preliminary efficacy of occupational therapy integrating horses on self-regulation in youth with autism

Conditions: Autism Spectrum Disorder

Summary: the goal of this clinical trial is to learn about occupational therapy integrating horses for autistic youth. the main questions it aims to answer are: * does occupational therapy integrating horses improve self-regulation in autistic youth * does occupational therapy integrating horses affect salivary cortisol and alpha-amylase participants will receive 10 weeks of occupational therapy, and will be asked to provide saliva samples each week. researchers will compare occupational therapy integrating horses to occupational therapy in a clinic to see if integrating horses affects self-regulation.

the goal of this project is to quantify the unique benefits of integrating horses in occupational therapy compared to occupational therapy in a clinic (i.e., otee hors vs. ot clinic) for improving self-regulation in youth with asd. to address both aims we will randomize 64 youth with asd ages 6-11 years old to otee hors or ot clinic. specific aim 1: examine the preliminary efficacy of otee hors compared to ot clinic on self-regulation. hypotheses: the otee hors group will demonstrate significantly larger improvements than the ot clinic group in five domains of self-regulation (hyperactivity \[primary\], irritability, emotional reactivity, dysphoria, and individual goal attainment). specific aim 2: identify potential physiological mechanisms that explain how integration of horses in occupational therapy impacts self-regulation in youth with asd. hypotheses 2a \& b: the otee hors group will demonstrate significantly larger decreases in salivary cortisol after each 60-minute therapy session and after the 10-week treatment course in comparison to the ot clinic group. hypotheses 2c \& 2d: the otee hors group will demonstrate significantly greater increases in salivary alpha-amylase after each 60-minute therapy session, and significantly greater decreases in salivary alpha-amylase over time as measured after the 10-week treatment course in comparison to the ot clinic group. exploratory hypothesis 2e: changes in physiological measures will significantly correlate with changes in aim 1 behavioral measures.

Eligibility criteria:
inclusion criteria: * meet clinical cut-offs for asd on the autism diagnostic observation schedule, second edition(ados-2) and social communication questionnaire (≥ 11) * nonverbal iq≥65 on leiter international performance scale third edition (leiter-3) * verbally fluent defined by meeting standard administration criteria for ados-2 module 3 * score \>10 on the irritability subscale of the aberrant behavior checklist * able to tolerate a helmet and ride a horse for 10 minutes while following safety rules * and able to provide a saliva sample exclusion criteria: * weigh more than 200 pounds * smoke or regularly use steroids * receive outpatient occupational therapy * have 10+ hours horseback riding experience in the previous 6 months * history of animal abuse or phobia of horses * have a sibling previously enrolled in the study

Keywords: occupational therapy hippotherapy equine-assisted services self-regulation